Hospitalization rates, morbidity, and mortality from childhood asthma continue to increase despite scientific advances that have improved our understanding of the pathophysiology of asthma and the availability of more effective therapy for its management. Inhaled corticosteroids are considered to be the mainstay of pharmacological treatment for persistent asthma. However, there is a growing body of literature documenting under utilization of anti-inflammatories by patients. The reasons for this are unclear. Before interventions to enhance appropriate anti-inflammatory use can be designed and tested, we need to know more about the barriers to their use and have a psychometrically sound instrument to measure them. The overall aim of this study is to identify barriers to appropriate anti-inflammatory use in childhood asthma and to develop an instrument that may be useful in both research and health care settings to identify at risk populations and circumstances. The specific aims are: are: 1) to identify the domains of parental beliefs and attitudes related to anti-inflammatory use in their children with asthma; 2) to develop and test a questionnaire that reflects the beliefs and attitudes affecting anti-inflammatory use that is reliable and valid. The sample will consist of 109 parents of children with moderate to severe asthma who are currently enrolled in two clinical trials evaluating symptom perceptual accuracy and symptom monitoring strategies. Extensive demographic and disease related data is available for this population of children. We will collect data for instrument development in 4 phases: 1) Identification of potential domains of barriers to anti-inflammatory use: The professional perspective, 2) Content validation: Gaining the parent perspective, 3) Pre-testing and refinement of the Instrument, 4) Pilot testing. We will use classic psychometric techniques for tool development and testing.